Objective To investigate the safety and efficacy of surgery in 121 patients with spinal metastases.Methotds A retrospective analysis of clinical data from April 2009 to March 2013 was performed in 121 patients with spinal metastases.From 37 to 65 years,69 males and 42 females with mean age of 55.6 years.Primary tumor origin:Lung 35(28.9％),Breast 26(21.4％),Renal 17 (14.0％),Prostate 20 (16.5％),Thyroid 14 (11.6％),Liver 2 (1.7％),Colon 1 (0.8％),other 6 (5.0％).All patients received surgery.Follow-up and survival time were analyzed.In preoperation and postoperative 3 month,pain levels were assessed by visual analogue scale (VAS),neurologic deficit was evaluated by Frankel Grade and functional impairment was classified by Karnofsky Score.The quality of the life was assessed by EORTC QLQ-C30 questionnaire.Survival analysis was evaluated by Kaplan-meier.Results The period of follow-up ranged from 5 to 35 months with the average of 15.9 months.The mean survival was 14.5 months.1-year survival was 53.5％.2-year survival was 36.5％.In patients with lung cancer,the mean survival was 8.5months.1-year survival was 14.3％.2-year survival was 11.4％.In patients with breast cancer,the mean survival was 31 months.1-year survival was 57.7％.2-year survival was 46.2％.In preoperation and postoperative 3 month,the VAS showed statistical significance (t=21.6,P＜0.01) ;Post-operatively,80.3％ of all patients had functionally useful Frankel Grade D or E compared with 43.5％ pre-operatively.KPS score (80-100) percentage was 75.6％ postoperatively compared with 33.4％ preoperatively.In 1month postoperatively,35 of 75 patients who were sphincteric dysfunction preoperatively were improved.The EORTC QLQ-C30score was 83.39±7.23 in preoperation and 51.34±14.27 in postoperaion.The quality of life was impoved significantly (t=12.6,P＜0.01).Conclusion Surgical treatment was effective in improving quality of life by providing better pain control,enabling patients to regain or maintain mobility,and offering improved sphincter control.In all patients,the number of patents with spinal metastases from breast and lung cancer is higher.Compared with spinal metastases from breast cancer,the proportion of lung cancer origin received surgery is higher.

ObjectiveTo investigate the safety and efficacy of combined treatment with subtotal corpectomy and radiofrequency ablation(RFA) for spinal metastases. MethodsFrom April 2009 to March 2010, 29 patients with spinal metastases who received subtotal corpectomy were analyzed. Sixteen patients (7 men and 9 women) with an average of 57.8 years having received subtotal corpectomy alone were selected for comparison (the subtotal corpectomy group). Thirteen patients (7 men and 6 women) with an average of 58.3 years having received subtotal corpectomy combined with RFA were chosen as subjects of this study (the RFA combination group). There were no significant differences between the two groups with respect to the patient's age, gender, and Tomita type. Pain levels pre-and post-procedure were assessed by the visual analogue scale(VAS), and neurologic deficit were evaluated by the Frankel scale. ResultsThe VAS in RFA combination group were 8.88±0.36, 3.76±0.33, 3.35±0.38 in preoperation, 1 month, and 6 months postoperatively, respectively. The VAS in subtotal corpectomy group were 8.96±0.39, 3.81 ±0.48, 3.41 ±0.42 in preoperation, 1 month, and 6 months postoperatively, respectively. The VAS in both groups showed statistical significance at each time point, there was no statistically difference between the two groups. The operate time in RFA combination group and subtotal corpectomy group were(216.54±113.77) min and(302.50±80.44)min, respectively. The blood loss of the two groups were (1084.62±539.82)ml and (1625.00±724.34)ml, respectively. The recurrent rate of the two groups were 30.8％ and 75.0％, respectively. The RFA combination group were lower in operate time, blood loss and recurrent rates than subtotal corpectomy group. Conclusion Compared with the subtotal corpectomy, the RFA combination can reduce the blood loss, operation time, and the recurrent rates.

AIM: To investigate the effects of metformin on airway inflammation, remodeling and neovascularization in a mouse model of chronic asthma and its possible mechanisms.METHODS: BALB/c mice were randomly divided into saline group, ovalbumin (OVA) group and OVA+metformin group, with 8 in each.At the end of OVA exposure, blood and bronchoalveolar lavage fluid (BALF) were collected for the measurement of OVA specific IgE and leukocyte counts.Lung tissue sections were stained with hematoxylin-eosin, periodic acid-Schiff and Masson's trichrome to detect inflammatory cell infiltration, goblet cell hyperplasia, and collagen deposition around the airway, respectively.Immunohistochemistry was used to evaluate the number and percentage area of new blood vessels (CD31+), and the protein level of phosphorylated AMP-activated protein kinase (p-AMPK) in the airway.RESULTS: Compared with saline group, the eosinophil percentage and OVA specific IgE in serum in OVA group were all increased obviously (P<0.01).Metformin inhibited the above increases (P<0.05).Compared with control group, a marked increase in inflammation infiltration, PAS+ cells and collage deposition in the airway mucosa in OVA group were observed.Metformin partially relieved the above changes.CD31+ vessels in the wall of bronchi showed the abundance of blood vessels observed in OVA group compared with control group, which was suppressed by the treatment with metformin (P<0.05).The protein level of p-AMPK was reduced in the lung tissue challenged with OVA as compared with control group (P<0.05), while metformin increased the protein level of p-AMPK (P<0.01).CONCLUSION: The protein level of p-AMPK in the airway in OVA group is attenuated.Metformin effectively inhibits airway inflammation, remodeling and neovascularization possibly via activating AMPK signaling pathway.

Objective To discuss the related factors of early pathological fracture after curettage of benign bone tumors in femoral shaft.Methods The clinical data of 47 patients with benign bone tumors in femoral shaft,treated by curettage with bone graft via the vastus lateralis approach from March 2004 to March 2011,were retrospectively analyzed.Thirteen patients of them presented with early pathological fracture after the curettage.In fracture group,there were 13 cases,11 males and 2 females,and the time from finishing curettage to fracture occurring ranged from 21 to 36 days.In non-fracture group,there were 34 cases,23 males and 11 females.The following data of fracture group and non-fracture group were compared and analyzed,such as specific value of absolute width of tumor and transverse diameter of bone shaft,specific value of defect width of bone window and sagittal diameter of bone shaft,defect length-width ratio of bone window,defect morphology of bone window,classification of bone tumor,violence of causing injury and compliance to medical advice.Results The average defect length-width ratio of bone window in fracture group was 3.72±3.58,in non-fracture group was 2.67±6.35.For classification of tumor,in fracture group 1 case was in incubation period,6 in active period,6 in invasion period; in non fracture group 21 cases were in incubation period,10 in active period,and 3 in invasion period.Four cases in fracture group had poor compliance to medical advice,and 9 in non-fracture group had good compliance.Between two groups,there were no statistical differences in specific value of absolute width of tumor and transverse diameter of bone shaft,specific value of defect width of bone window and sagittal diameter of bone shaft,and defect morphology of bone window.Conclusion When defect length-width ratio of bone window is larger than 4,the classification of tumor causes expanded incisal edge,and the cortical bone was damaged extensively,there are more possibilities for pathological fracture.

Objective To compare the curative effect of conservative treatment and full thread hollow screw in the treatment of Ekrol 2 fracture of the fifth metatarsal bone.Methods From April 2013 to May 2015,42 patients with avulsion fractures of the fifth metatarsal basement of type 2 fractures in Ekrol division were treated in our hospital.23 patients underwent full thread hollow screw surgery (surgical treatment group),and there were 12 males and 11 females,with an average age of 43.4±9.2 years,and the fracture displacement length was 2.3±0.2 mm.19 patients treated with plaster fixation (conservative group),including 10 males and 9 females,with an average age of 45.7±8.9 years and fracture displacement length was 2.1±0.2 mm.During follow-up,X -ray examination was performed to evaluate the time of fracture healing and forefoot score of American Orthopaedic Foot and Ankle Society (AOFAS),visual analogue score (VAS) and quality of life questionnaire (SF-36) were compared between the two groups.Results All 42 patients were followed up for 12 to 24 months with an average of 18 months.At the latest follow-up,the fracture healing time of the surgical group was 9.3±2.0 weeks,with AOFAS score of 84.1±3.9,VAS score of 0.1±0.2,and the SF-36 score of 95.1±2.9 points,and the shortening of length after treatment was 2.1±2.5 mm;the average healing time of the conservative treatment group was 12.2±2.1 weeks,with the average AOFAS score of 84.2±4.2 points,and the average VAS score of 0.2±0.2 points,the average SF-36 score of 94.1 ±5.2 points,and the shortening of length after treatment was 0.4±2.5 mm.The results of each short-term score and the shortening of the length of the fracture after treatment was statistically significant.The results of the mid-and long-term scores showed no significant difference between the two groups;the fractures of both groups reached bone healing.3 cases of sural nerve stimulation occurred in the operation group,while 1 case occurred in the conservative group.Abnormal healing occurred in 2 cases of conservative treatment,and the fractures of the surgical treatment group were anatomic reduced.Conclusion Usingfull thread hollow screwfor the treatment of Ekrol 2 fracture of the fifth metatarsal bone is better than the conservative treatment in the short term,but there is no significant difference in the long-term effect.

OBJECTIVE: To study the expression of CD44 and nm23-H1 gene proteins and their clinical significance in laryngeal carcinoma. METHOD: The expression of CD44 and nm23-H1 proteins were detected by immunohistochemistry method in 40 cases with laryngeal carcinoma, 20 adjacent carcinoma tissues and 12 cases normal laryngeal mucosa tissues. RESULT: The expression of CD44 and nm23-H1 proteins in laryngeal carcinoma were much higher than that in normal laryngeal mucosa. The expression of CD44 protein in laryngeal carcinoma with metastatic lymph node was higher than that in laryngeal carcinoma without metastatic lymph node, but nm23-H1 protein lower. The expression of CD44 protein was positively correlated with the metastasis, clinical staging and pathological classification but not correlated with T classification of laryngeal carcinoma. The expression of nm23-H1 protein was negative correlation with the metastasis and clinical staging of laryngeal carcinoma. CONCLUSION CD44 and nm23-H1 gene proteins play an important coordinated regulation role in the carcinogenesis, development and metastasis of laryngeal carcinoma and will probably become the key biological marks in the judging and evaluating prognosis of laryngeal carcinoma.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Hyaluronan Receptors ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; metabolism ; Neoplasm Staging

Objective:To investigate the association between pulse pressure(PP) and new-onset diabetes in overweight and obese people.Methods:A prospective cohort study was conducted in overweight or obese participants selected from Kailuan Study who underwent 2006-2007 annual checkup and met the inclusion and exclusion criteria. PP was calculated by blood pressure and participants were divided into 4 groups according to PP quartile. The cumulative incidence of new-onset diabetes of different PP groups was calculated by Kaplan- Meier method and compare by Log- Rank test. The multivariate Cox proportional hazards model was used to analyze the association between different PP groups and new-onset diabetes. Results:During an average follow-up of 8.45 years, 8 922 diabetes was identified. The cumulative incidence rate of the Q1, Q2, Q3, and Q4 groups were 22.12%, 24.48%, 27.97%, and 33.44% respectively, which were statistically different( χ2=368.16, P<0.01). Cox proportional hazards regression analysis showed that after adjusting for multiple confounding factors, compared with Q1 group, the hazard ratio for diabetes in Q2, Q3, and Q4 groups were 1.07(1.00-1.14), 1.13(1.05-1.21), and 1.17(1.09-1.27) respectively. And the HR of diabetes event in pulse pressure(per 1 SD increase) was 1.04(1.02-1.07). Similar results were found in participants who were over-weight, obese, with normal blood pressure or hypertensive without drugs use. Conclusion:PP is positively correlated with the new-onset diabetes. High PP is one of the risk factors for developing diabetes in overweight and obese people.

Objective:To investigate the value of serum urea nitrogen on in-hospital death in patients with heart failure.Methods:The clinical data of 9 459 patients with heart failure from January 2013 to December 2018 in Shengjing Hospital of China Medical University were retrospectively analyzed. Among them, 296 cases died in hospital (death group) and 9 163 cases survived (survival group). The clinical data of patients were collected, including general condition, disease history, physical examination, laboratory indicators and relevant physical examination, etc. Correlation was finished with Pearson correlation analysis. Multivariate Logistic regression analysis was used to determine independent risk factors for in-hospital death in patients with heart failure. Receiver operating characteristic (ROC) curve was used to determine the optimal predictive threshold of urea nitrogen for in-hospital death.Results:The in-hospital mortality in patients with heart failure was 3.1% (296/9 459). There were statistical differences in age, hypertension rate, diabetes rate, a history of atrial fibrillation rate, smoking history rate, hemoglobin, albumin, glycosylated hemoglobin, urea nitrogen, creatinine, uric acid, serum potassium, serum sodium, troponin I, N terminal brain natriuretic peptide precursor (NT-proBNP), left ventricular ejection fraction (LVEF) between death group and survival group ( P<0.01 or <0.05), and there were no statistical difference in gender composition, coronary heart disease rate, platelet, total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglyceride, left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) between 2 groups ( P>0.05). Pearson correlation analysis result showed that the urea nitrogen was positively correlated with age, coronary heart disease, hypertension, diabetes, glycosylated hemoglobin, creatinine, uric acid, serum potassium, troponin I, NT-proBNP, LVEDV and LVESV ( r = 0.130, 0.024, 0.053, 0.128, 0.033, 0.739, 0.468, 0.377, 0.065, 0.432, 0.084 and 0.101; P<0.01 or <0.05); and the urea nitrogen was negatively correlated with gender, history of atrial fibrillation, hemoglobin, platelet, albumin, total cholesterol, LDL-C, serum sodium and LVEF ( r = -0.033, -0.063, -0.272, -0.077, -0.188, -0.070, -0.071, -0.199 and -0.113, P<0.01); and there were no correlation between urea nitrogen and smoking history or triglyceride ( P>0.05). Multivariate Logistic regression analysis result showed that age, hypertension, albumin, urea nitrogen, troponin I and NT-proBNP were independent risk factors for in-hospital death in patients with heart failure ( OR = 1.018, 0.613, 0.924, 1.082, 1.340 and 1.005; 95% CI 1.002 to 1.033, 0.427 to 0.881, 0.889 to 0.961, 1.040 to 1.126, 1.111 to 1.617 and 1.003 to 1.007; P<0.05 or <0.01). ROC curve analysis result showed that the area under the curve (AUC) of urea nitrogen for prediction of in-hospital death in patients with heart failure was 0.737 (95% CI 0.728 to 0.748), and the optimal threshold value was 11.41 mmol/L, with a sensitivity of 60.16% and a specificity of 77.01%; the AUC of NT-proBNP for prediction of in-hospital death in patients with heart failure was 0.726 (95% CI 0.712 to 0.740), and there was no statistical difference in the AUC between urea nitrogen and NT-proBNP ( Z=1.055, P=0.291). Conclusions:Elevated urea nitrogen level is independently associated with an increase in in-hospital mortality in patients with heart failure, and the optimal threshold for predicting in-hospital death is 11.41 mmol/L.

Objective:To explore the relationship of telomere length, mitochondrial DNA copy number of peripheral blood with hypertension and the interaction between telomere length and mtDNA-CN on hypertension in coal miners.Methods:A case control study was conducted in a coal mine of Shanxi province from July to December of 2013, in which 325 healthy workers were selected as the control group and 378 workers with hypertension as the case group. The information about general demographic characteristics and life behavior habits of the subjects were collected through questionnaire. Levels of telomere length and mtDNA-CN in peripheral blood were detected by real-time PCR. Unconditional logistic regression was used to examine the association between hypertension and telomere length, mtDNA-CN. The interaction test between telomere length and mtDNA-CN on hypertension was performed by adding the interaction term in the corresponding model.Results:The mean telomere length of the workers in the case group was (1.50±0.55) kb, and that of the control group was (2.01±0.62) kb, the difference between two groups was significant ( t=11.68, P<0.001). The correlation analysis showed that telomere length was positively correlated with mtDNA-CN ( r=0.157, P=0.002) in the case group. Multivariate analysis showed that telomere length ( OR=4.408, 95% CI: 3.012-6.452), age ( OR=0.417, 95% CI: 0.284-0.613), BMI ( OR=1.357, 95% CI: 1.162-1.584), monthly household income level ( OR=0.656, 95% CI: 0.553-0.778) and work duration ( OR=1.249, 95% CI: 1.100-1.417) were influencing factors of hypertension. The multiply interaction between telomere length and mtDNA-CN was significant on hypertension ( OR=1.267, 95% CI: 1.094-1.468). Conclusions:The results suggest shorter telomere length is a risk factor of hypertension. There is a multiply interaction between telomere length and mtDNA-CN on hypertension. However, the association between mtDNA-CN and hypertension was not found.

Objective This study aims to investigate the therapeutic effect and mechanism of Naoxinqing on non-alcohol fatty liver disease (NAFLD) induced by a high-fat diet through network pharmacology,molecular docking and in vitro and in vivo experiments. Methods ApoE-/-mice were given a high-fat diet for 12 weeks to establish the NAFLD model,followed by a 12-week Naoxinqing administration. To evaluate the therapeutic effect of Naoxinqing on NAFLD induced by a high-fat diet,biochemical and histopathological experiments were performed,including assessment of blood lipids,liver function,serum inflammatory factors,as well as Hematoxylin and eosin (HE),Oil red O,and Sirius red staining of liver. Subsequently,network pharmacology and molecular docking techniques were employed to predict the key targets of Naoxinqing. Finally,the mechanism of Naoxinqing was validated by Western Blot in HepG2 cells and liver tissue. Results The results of serum biochemistry and liver tissue pathology showed that Naoxinqing can significantly improve high-fat diet-induced hepatic lipid accumulation,hepatocellular injury,and inflammation. Network pharmacology and molecular docking analysis results suggested that Naoxinqing may affect lipid metabolism through the AMP-activated protein kinase (AMPK)/Sirtuin 1 (SIRT1) pathway. Finally,in vitro cell experiment confirmed that the main mechanism of Naoxinqing is to activative the AMPK/SIRT1 pathway,upregulate the expression of downstream carnitine palmitoyltransferase 1 (CPT1A),promote fatty acid oxidation,and ultimately improve NAFLD. Conclusion This study demonstrated that Naoxinqing improved NAFLD by promoting fatty acid oxidation through the activation of the AMPK/SIRT1 pathway.